Teaching Evidence-Based Medicine and Non-conventional (Alternative) Therapies in Portuguese Veterinary Schools—A Curricular Assessment
Publication: Journal of Veterinary Medical Education
Volume 51, Number 5
Abstract
Applying evidence-based veterinary medicine (EBVM) is considered a Day One competence for veterinary graduates. Furthermore, the increasing interest in the use of complementary and alternative (non-conventional) veterinary therapies (NCTs) must be grounded on EBVM principles. Few studies have mapped the teaching of EBVM and of NCTs and assessed their content. This study analyses the official curricula of six (out of eight) Portuguese veterinary schools in terms of EBVM and NCTs, using the self-evaluation documents submitted to the National Agency for Assessment and Accreditation of Higher Education (A3ES) (2014–2015). Results show that, with few exceptions, veterinary education in Portugal follows a traditional, clinically-driven approach to evidence, with concepts taught mostly from an empirical and experiential perspective instead of a systematic one. Core EBVM topics, such as placebo effect, methodological validity, PICO, cognitive bias, and systematic review are either absent or insufficiently covered. Moreover, the teaching of NCTs was found in three out of the six curricular programs, namely acupuncture, phytotherapy, homeopathy, traditional Chinese medicine, aromatherapy, Bach flower remedies, ayurveda, energetic healing (reiki), and massage. We found no evidence that these therapies are being taught under the principles of EBVM. Taken together, these results highlight the need for more explicit and targeted teaching of EBVM-related topics, namely regarding the critical appraisal of scientific literature and the integration of best evidence into clinical decision-making. Results can also be useful to inform the accreditation process by the A3ES and by education quality assurance agencies in other jurisdictions.
Get full access to this article
View all available purchase options and get full access to this article.
Supplemental Material
jvme-2023-0055_supplement1.pdf
- Download
- 439.73 KB
Supplemental Material
jvme-2023-0055_supplement2.pdf
- Download
- 342.18 KB
References
1.
Straus SE, Glasziou P, Richardson WS, Haynes RB. Evidence-based medicine E-Book: how to practice and teach EBM. Elsevier Health Sciences; 2018. p. 358.
2.
Shurtz S, Fajt V, Heyns EP, Norton HF, Weingart S. Teaching evidence-based veterinary medicine in the US and Canada. J Vet Med Educ. 2017;44(4):660–8. https://doi.org/10.3138/jvme.1215-199R.
3.
RCVS Knoweldge. EBVM learning: an introduction to evidence-based veterinary medicine [Internet]. [cited 2022 Jan 25]. Available from: https://learn.rcvsknowledge.org/course/view.php?id=2
4.
May SA. Clinical reasoning and case-based decision making: the fundamental challenge to veterinary educators. J Vet Med Educ. 2013;40(3):200–9. https://doi.org/10.3138/jvme.0113-008R.
5.
Cockcroft PD, Holmes MA. Handbook of evidence-based veterinary medicine. Oxford: Wiley-Blackwell; 2003. p. 226.
6.
Domingues K, Franco NH, Rodrigues I, Stilwell G, Magalhães-Sant’Ana M. Bibliometric trend analysis of non-conventional (alternative) therapies in veterinary research. Vet Q. 2022;42(1):192–8. https://doi.org/10.1080/01652176.2022.2142318.
7.
Gilberg K, Bergh A, Sternberg-Lewerin S. A questionnaire study on the use of complementary and alternative veterinary medicine for horses in Sweden. Animals (Basel). 2021;11(11):3113. https://doi.org/10.3390/ani11113113.
8.
Keller P, Vanwesenbeeck I, Hudders L, Decloedt A. Horse owners’ attitudes towards and motivators for using complementary and alternative veterinary medicine. Vet Rec. 2021;189(2):e303. https://doi.org/10.1002/vetr.303.
9.
Stanossek I, Wehrend A. Application of veterinary naturopathy and complementary medicine in small animal medicine—A survey among German veterinary practitioners. PLoS One. 2022;17(2):e0264022. https://doi.org/10.1371/journal.pone.0264022.
10.
Alternative and Complementary Therapies Task Force. An insight into the AVMA guidelines for complementary and alternative veterinary medicine. J Am Vet Med Assoc. 2001;218(11):1729–30. https://doi.org/10.2460/javma.2001.218.1729.
11.
Memon MA, Sprunger LK. Survey of colleges and schools of veterinary medicine regarding education in complementary and alternative veterinary medicine. J Am Vet Med Assoc. 2011;239(5):619–23. https://doi.org/10.2460/javma.239.5.619.
12.
Memon MA, Shmalberg JW, Xie H. Survey of integrative veterinary medicine training in AVMA-accredited veterinary colleges. J Vet Med Educ. 2021;48(3):289–94. https://doi.org/10.3138/jvme.2019-0067.
13.
St-Hilaire S, Nekouei O, Parkes RSV, Rosanowski SM. Active learning for an evidence-based veterinary medicine course during COVID-19. Front Vet Sci. 2022;9:953687. https://doi.org/10.3389/fvets.2022.953687.
14.
Steele M, Crabb NP, Moore LJ, Reyher KK, Baillie S, Eisler MC. Online tools for teaching evidence-based veterinary medicine. J Vet Med Educ. 2013;40(3):272–7. https://doi.org/10.3138/jvme.0113-010R1.
15.
Sin C, Tavares O, Amaral A. The impact of programme accreditation on Portuguese higher education provision. Assess Eval Higher Educ. 2017;42(6):860–71.
16.
Agência de Avaliação e Acreditação do Ensino Superior. Guidelines for self-assessment of study programmes in operation (ACEF 2018-2023) [Internet]; 2018 [cited 2023 Jan 5]. Available from: https://www.a3es.pt/en/accreditation-and-audit/guidelines/assessment/accreditation-study-programmes-operation
17.
Lei n.o 38/2007 - Diário da República n.o 157/2007, Série I de 2007-08-16| DRE [Internet]. Diário da República Eletrónico. [cited 2022 Feb 8]. Available from: https://dre.pt/
18.
O’Brien BC, Harris IB, Beckman TJ, Reed DA, Cook DA. Standards for reporting qualitative research: a synthesis of recommendations. Acad Med. 2014;89(9):1245–51. https://doi.org/10.1097/ACM.0000000000000388.
19.
Leiber T, Stensaker B, Harvey LC. Bridging theory and practice of impact evaluation of quality management in higher education institutions: a SWOT analysis. Eur J Higher Educ. 2018;8(3):351–65. https://doi.org/10.1080/21568235.2018.1474782
20.
Diário da República. Lei n.o 71/2013 de 2 de setembro. Regulamenta a Lei n.o 45/2003, de 22 de agosto, relativamente ao exercício profissional das atividades de aplicação de terapêuticas não convencionais [Internet]. Lei n.o 71/2013 de 2 de setembro Sep 2, 2013. Available from: https://dre.pt/dre/detalhe/lei/71-2013-499569
21.
Cake MA, Bell MA, Williams JC, et al. Which professional (non-technical) competencies are most important to the success of graduate veterinarians? A Best Evidence Medical Education (BEME) systematic review: BEME Guide No. 38. Med Teach. 2016;38(6):550–63. https://doi.org/10.3109/0142159X.2016.1173662.
22.
Dean R, Brennan M, Ewers R, et al. The challenge of teaching undergraduates evidence-based veterinary medicine. Vet Rec. 2017;181(11):298–9. https://doi.org/10.1136/vr.j3441.
23.
Gibbons PM, Anderson SL, Robertson S, Thurman FK, Hunt JA. Evaluation of an evidence-based veterinary medicine exercise for instruction in clinical year of veterinary medicine program. Vet Rec Open. 2021;8(1):e3. https://doi.org/10.1002/vro2.3.
24.
Bergh A, Lund I, Boström A, Hyytiäinen H, Asplund K. A systematic review of complementary and alternative veterinary medicine: “Miscellaneous Therapies.” Animals (Basel). 2022;12(11):1440. https://doi.org/10.3390/ani12111440.
25.
Lees P, Pelligand L, Whiting M, Chambers D, Toutain PL, Whitehead ML. Comparison of veterinary drugs and veterinary homeopathy: part 1. Vet Rec. 2017;181(7):170–6. https://doi.org/10.1136/vr.104278.
26.
Magalhães-Sant’Ana M. The Emperor's new clothes—an epistemological critique of Traditional Chinese veterinary acupuncture. Animals (Basel). 2019;9(4):168. https://doi.org/10.3390/ani9040168.
27.
Sofyan LM. Are glucocorticoids or NSAIDs more effective in reducing idiopathic feline urinary tract disease signs than no treatment or placebo? Vet Evid. 2021;6(3)). Available from: https://veterinaryevidence.org/index.php/ve/article/view/439
28.
McKenzie BA. Veterinary clinical decision-making: cognitive biases, external constraints, and strategies for improvement. J Am Vet Med Assoc. 2014;244(3):271–6. https://doi.org/10.2460/javma.244.3.271.
29.
Mahdi JG, Mahdi AJ, Mahdi AJ, Bowen ID. The historical analysis of aspirin discovery, its relation to the willow tree and antiproliferative and anticancer potential. Cell Prolif. 2006;39(2):147–55. https://doi.org/10.1111/j.1365-2184.2006.00377.x.
30.
Miller LH, Su X. Artemisinin: discovery from the Chinese Herbal Garden. Cell. 2011;146(6):855–8. https://doi.org/10.1016/j.cell.2011.08.024.
31.
Dent J, Harden RM, Hunt D, editors. A practical guide for medical teachers. 6th ed. London New York Oxford Philadelphia St. Louis Sydney Toronto: Elsevier; 2021. p. 496.
Information & Authors
Information
Published In
Journal of Veterinary Medical Education
Volume 51 • Number 5 • October 2024
Pages: 685 - 694
Copyright
© American Association of Veterinary Medical Colleges (AAVMC), 2024. For their own personal use, users may read, download, print, search, or link to the full text. Manuscripts published in the Journal of Veterinary Medical Education are copyrighted to the American Association of Veterinary Medical Colleges. Requests for permission to reproduce this article should be made to the University of Toronto Press using the Permission Request Form: https://www.utpjournals.press/about/permissions or by email: [email protected].
History
Received: 31 March 2023
Revision received: 13 May 2023
Accepted: 15 May 2023
Published ahead of print: 1 September 2023
Published online: 15 October 2024
Published in print: October 2024
Key Words:
Data Access Statement
Official access to the original documents analyzed in this research can be found in Table A1, Appendix A. A summary of the findings of the content analysis is available as Supplementary Material.
Authors
Conflict of Interest
MM-S is the representative member of the Portuguese Veterinary Order (Ordem dos Médicos Veterinários) at the Advisory Council of the Agency for Assessment and Accreditation of Higher Education (A3ES) since 2018. The remaining authors declare no conflict of interest. This research is part of the EVIEDVET project, funded by FCT. The funder had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.
Funding
This research was funded by Fundação para a Ciência e a Tecnologia (FCT), I. P., Portugal (project number: PTDC/CED-EDG/ 0187/2020). The APCs were funded by FCT-Fundação para a Ciência e a Tecnologia, I.P., Portugal, through CIISA (UIDB/00276/2020) and AL4AnimalS (LA/P/0059/2020).
Metrics & Citations
Metrics
Related Content
Citations
If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download.
Download article citation data for:
Journal of Veterinary Medical Education 2024 51:5, 685-694
Journal of Veterinary Medical Education 2024 51:5, 685-694